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目的探讨胸锁乳突肌外侧径路在甲状腺癌侧颈部淋巴结清扫中的应用价值。方法侧颈部淋巴结清扫中采用胸锁乳突肌外侧径路组(实验组)甲状腺癌患者40例,侧颈部淋巴结清扫中采用传统手术方式(对照组)40例,比较两组患者清扫范围达标率、手术时间、并发症的发生率。结果实验组患者在手术中均能达到根治的目的,术野显露更加清楚,Ⅱ、Ⅲ、Ⅳ、Ⅴ区淋巴结清扫数目(32枚,58枚,50枚,35枚)均高于传统手术组(17枚,35枚,33枚,20枚)。实验组手术时间平均(30.0±1.20)分钟,对照组为(45.0±3.10)分钟,实验组手术时间明显缩短,两组患者近、远期并发症总体发生率比较,差异有统计学意义(P<0.05)。结论胸锁乳突肌外侧径路在甲状腺癌侧颈部淋巴结清扫中可以达到根治的目的,可提高Ⅱ、Ⅲ、Ⅳ、Ⅴ区淋巴结清扫数目,缩短手术时间,降低近、远期并发症发生率。
Objective To investigate the value of sternocleidomastoid lateral pedicle pathways in the dissection of lateral cervical lymph nodes in thyroid cancer. Methods Forty patients with thyroid carcinoma underwent lateral sternocleidomastoid approach (experimental group) and 40 patients underwent conventional surgical approach (control group) in the treatment of lateral cervical lymph node dissection. The clearance range of the two groups was reached Rate, operation time, the incidence of complications. Results All the patients in the experimental group achieved the goal of radical operation during operation. The operative field revealed more clearly. The number of lymphadenectas in group Ⅱ, Ⅲ, Ⅳ and Ⅴ (32, 58, 50, 35) were higher than those in the conventional operation group (17, 35, 33, 20). The average operation time was 30.0 ± 1.20 minutes in the experimental group and 45.0 ± 3.10 minutes in the control group. The operation time of the experimental group was significantly shortened, and the overall incidence of proximal and long-term complications in the two groups was statistically significant (P <0.05). Conclusion The lateral approach of sternocleidomastoid muscle can achieve radical curative effect in lateral lymphadenectomy of thyroid carcinoma, which can increase the number of lymphadenectas in group Ⅱ, Ⅲ, Ⅳ and Ⅴ, shorten the operation time and reduce the incidence of complications .